Staff nurse decisional involvement: an Internet mixed-method study in Taiwan

Abstract

(a) To explore staff nurses' actual decisional involvement and preferred level of decisional involvement, the decisional dissonance, and the attributing factors; and (b) to understand staff nurses' perceptions about the process of decisional involvement at their work place in Taiwan. Research related to nurses' decisional involvement was scarce and mainly emphasized the level of involvement without examining the possible attributing factors and the process of nurses' decisional involvement. A two-phase internet mixed-method study design was used. A total of 125 staff nurses completed the internet survey using decisional involvement scale and 15 completed online forum discussion questions. Nurses' actual decisional involvement was significantly lower than preferred decisional involvement. The attributing factor to nurses' actual decisional involvement included the level of education, type of hospital, work unit and workload. There were no differences of preferred decisional involvement among different demographic data. Regarding nurses' perceptions of decisional involvement, three themes were identified: dependent on administrators, fear of getting into trouble, and the power of consensus. The low level of actual decisional involvement and preferred decisional involvement might be associated with workload, management style and the fear of getting into troubles. The government, health care organisations, nursing leaders should reexamine the influence of work setting factors, workload and management style to nurses' actual decisional involvement.